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  • Rob

Lateral epicondyl-what?

Tennis elbow is a funny name for a condition.  Especially when the research shows that the majority of the people who suffer from this have never played tennis!!

The fancy name is lateral epicondylitis.  The -itis on the end of that word means inflammation.

Inflammation is usually only present for a few days after an acute injury.  Because of the prolonged nature of lateral epicondylitis to heal, the has been a relatively recent push to change the name to lateral epicondylalgia (LE).  This changes the meaning to lateral epicondyle pain, algia = pain, just like -itis = inflammation.

The lateral epicondyle is a point of bone on the outside of the elbow.  The point of bone is on the humerus, the upper arm bone.  What attaches to the lateral epicondyle is the common extensor tendon.  Basically, there are numerous muscles that attach to this tendon, muscles that extend your wrist and fingers.  Anatomy lesson: the body uses tendons to attach muscles to bone, class dismissed.  The thought is that when you strain one, or more, of the muscles, the injured muscles tighten up, to protect itself.  When the muscles tighten up, it adds tension onto the tendon.  Then tendon pulls on the bone.  Constant tension on the bone irritates the bone and soon any movement you do that pulls on the common extensor tendon which pulls on the bone, lateral epicondyle, hurts.

One aspect of LE is that it can be caused by numerous issues.  One often forgot additive to LE is the neck.  There are some areas in the neck that when the areas are irritated, the pain is felt in the lateral elbow.  In those cases, all the treatment in the world at the elbow will not help to get rid of your pain.  You would have to treat the client’s neck in conjunction with the elbow to get things to a pain-free state.  Some of my client’s will ask me, why am I looking at their necks, how does it move and how does it feel, when they are experiencing elbow pain.  Once explained, the client comes on board with the treatment.

A major  issue with getting this LE resolved is the fact that every time we use our hands, we are activating the muscles and pulling on the lateral epicondyle.  This is where using a brace may help someone suffering with this ailment.  The lateral epicondylitis brace usually has a bump on the inside.  You place this bump over the tender area and from there you tighten the brace.  Not so tight that you impair the circulation.  The theory with this is that the bump ‘cuts off’ the tension from making it to the lateral epicondyle, thereby relieving the pain and giving the injury a chance to heal.

Using a brace is simply one way to try and treat LE.  In my opinion, and is generally supported by the research, a multifactorial approach is the best way to treat.  That means using more than one treatment modality.  For example, only using the LE brace is considered to be treating with one factor.  Employing a treatment that uses manual therapy, soft tissue mobilization, intramuscular stimulation (IMS), education and exercise, the outcomes are better.

The most common thing I hear from my client’s suffering from LE is this.  They simply thought it would go away!  They were not sure how it started and so they figure it will simply disappear the same way.  I would say that the average person will suffer for 3-6 months (!!) before seeking some sort of medical advice, other than Dr. Google.  Once treatment is started pain relief will start but it does not seem to disappear as quickly as it came (it never does).

Are you suffering from lateral epicondylalgia/itis?  Call New Leaf Physiotherapy for an appointment to start your recovery today!

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